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General NPI Number Information
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NPI Number | 1285011098
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Entity Type | Organization
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Legal Business Name | JOHN M MORRIS DDS PLLC
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 1445 W SOUTHERN AVE SUITE 1212
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City | MESA
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State | AZ
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Zip | 85202-4803
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Country | US
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Telephone | 480-636-9970
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 W SOUTHERN AVE SUITE 1212
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City | MESA
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State | AZ
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Zip | 85202-4803
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Country | US
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Telephone | 480-636-9970
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST OWNER
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Name | JOHN M MORRIS
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Credential | DDS
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Telephone | 480-636-9970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D008050
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License Number State | AZ
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